Practice Question
What is the appropriate assumption to make when a head injury is suspected until a cervical injury is ruled out?
Answer Choices:
Correct Answer:
Assume there is a cervical spine injury
Rationale:
🩺 When a head injury is suspected, always assume a cervical spine injury until diagnostic imaging (e.g., X-ray, CT, MRI) rules it out.
🩺 This precaution prevents further spinal cord damage that could result in paralysis or neurological deficits.
🩺 The nurse should maintain cervical spine immobilization (e.g., cervical collar, log-rolling) during all assessments and transfers.
🩺 This is a standard trauma care principle following the ABC and spinal precautions protocols.
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This question is from RN Custom Exam 2 N221(Summer~2025) which contains 48 questions.
More Questions from This Exam
A nurse is caring for a client who has had a stroke involving the right hemisphere. Which of the following alterations in function should the nurse expect?
Answer Choices:
A. Inability to recognize his family members
B. Right hemiparesis
C. Aphasia
D. Difficulty reading
A nurse is teaching a client who has a prescription for HIV post exposure prophylaxis (PEP) about how to take the medications. Which of the following client statements indicates understanding of the teaching?
Answer Choices:
A. “I have up to 2 weeks after exposure to decide if I want to take these medications.”
B. “I don’t need to take the medication if I had an exposure via a needle stick.”
C. “I should not take these medications if I have high blood pressure.”
D. “I need to take the antiviral medications at the prescribed dosing times for the full 28 days to be effective.”
A nurse suspects that a client admitted for treatment of a bacterial meningitis is experiencing increased intracranial pressure (ICP). Which of the following assessment findings by the nurse Supports this suspicion?
Answer Choices:
A. Positive Kerning’s sign
B. Photophobia
C. Restlessness
D. Nuchal rigidity
A nurse is caring for a client who has psoriasis presenting as reddish/purple and flaky patches on their arms and legs. The nurse should be alert to which of the following potential complications of the condition?
Answer Choices:
A. Decreased breath sounds
B. Urinary tract infection
C. Hiatal hernia
D. Psychological distress
Which of the following statements is true regarding the use of phenytoin (Dilantin) in head injury?
Answer Choices:
A. Phenytoin is used to prevent or treat seizures.
B. Phenytoin can only be used in pediatric head injuries
C. Phenytoin is used in head injuries to decrease the risk of bleeding
D. Phenytoin is contraindicated in head injury
Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN Custom Exam(s)
- Answer Choices: 4